When Someone You Know Is Living in a Dementia Care Community

by Rachael Wonderlin
Johns Hopkins University Press, 2016
Review by Christian Perring on Jan 31st 2017

This is a simple guide for those with a loved one with dementia who has moved into a residential home. There are 29 short chapters on basic points and some not-so-basic. The author, Rachael Wonderlin, includes many illustrations from her own experience working in a care community. It's not clear whether her recommendations are based on science but she has got plenty of experience of how to reduce problems. The book starts out with some explanations of dementia and the why care communities might be appropriate. Then there is a lot of practical advice about what to do and what not to do when placing the person with dementia in the community and when visiting. Wonderlin recommends finding meaningful activities for the person with dementia that are within their capabilities -- and much of this involves engaging in activities or recalling events which the person used to do, whether it is cooking, singing, or past events. She emphasizes that it is not important to try to correct the person's false assumptions or ideas: what is important is that the person is happy. She emphasizes that even when you are moving a person to live in a residential home, there is no need to explain that this is a permanent move or that the person will be living away from their family now, for example, if this will just cause upset. It is much better to engage the person in an engrossing activity and leave quietly so that they don't get too upset. She argues that the new residents will settle in much better that way, while they will feel abandoned if a family tries to explain that they are saying goodbye and will only see the person with dementia on visits from now on. She further explains that people with dementia often have little comprehension of the severity of their condition and so don't understand why it is impossible for them to keep on living with their families any more.

While not everyone will agree with the recommendations Wonderlin makes, she does speak from experience. She keeps up a blog on dementia and has worked in long-term care for over ten years. Furthermore, the book is published by Johns Hopkins University Press and is labelled "A 36-Hour Day Book," linking it to the popular guide to caring for people with dementia. There is no doubt that many of the care-giving decisions for people with dementia are difficult, where families have to balance doing what is best for their loved one, maintaining the person's dignity and right to be treated with respect rather than like a child, and their own competing needs to be able to live their lives. Wonderlin does provide a lot of useful advice, and so this could be an excellent resource for people who know someone with dementia who is in, or who might be better off in, a residential facility.

Christian Perring teaches ethics, aesthetics and metaphysics in NYC.

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